The overall goal of the Penn TREC Survivor Center is to improve the length and quality of cancer survivorship through establishing a sustainable transdisciplinary research, education, and outreach program that extends from 'bench to trench'. The proposed center will enhance knowledge of the causal associations of energy balance and breast cancer recurrence, from animal to human models, as well as exploring and integrating this knowledge with broad population impact at the policy level for control of obesity related adverse events among cancer survivors. Three projects are proposed. Project 1 will explore whether exercise and/or weight loss will alter breast cancer recurrence in mice and explore effects on biomarkers of mechanistic pathways hypothesized to explain these effects. Project 2 will translate project 1 biomarker findings into a human model. Intervention effects on clinical lymphedema outcomes will also be assessed in Project 2. Project 3 will assess whether exercise and/or weight loss is cost effective for breast cancer survivors with lymphedema. Organizationally, the administrative core will serve as the glue between the investigators, so that as the projects, training activities, and developmental pilots unfold, the transdisciplinary, translational nature of the center is preserved and extended. The developmental core will accelerate capacity to study effects of energetics on cancer recurrence by combining the unique strengths of our institution in obesity and cancer biology and extending the TREC initiative solidly into cancer survivorship. The education/training and outreach core will train scientists and clinicians regarding energy balance and cancer survivorship, serving the dual purpose of educating health care providers regarding the unique energy balance issues in survivors and spurring interest in research on this growing population across the spectrum from basic science to clinical applications. The Penn TREC Survivor Center will leverage the considerable strengths of Penn scientific investigators and physician scientists to accelerate capacity for research on energetics, cancer recurrence and persistent adverse treatment effects as well as disseminating those findings to improve clinical care and outcomes for cancer survivors.